A Quarterly Publication of City of Hope | Volume 18 Number 3 | Summer 2007

Right on target

Researchers find new ways to improve chemotherapy

Kathleen O'Neil

As just about anyone who has undergone chemotherapy can attest, traditional cancer-killing drugs can damage healthy tissue, too. Gastrointestinal problems, hair loss, fatigue and other effects can accompany chemotherapy’s cancer-battling work.

But now City of Hope researchers and their colleagues may have found a way to focus chemotherapy more specifically on cancerous tissue. That may mean not only less toxic treatments, but also more effective ones.

Investigators at City of Hope and St. Jude Children’s Research Hospital are using modified neural stem cells to activate and concentrate chemotherapeutic drugs predominately at tumor sites, so that normal tissues surrounding the tumors and throughout the body remain relatively unharmed.

The investigative technique could help increase the chemotherapy doses that patients can safely tolerate, potentially increasing their cancer-cell-killing power. That may potentially bring good news for patients with advanced cancers that have spread.

“This approach could significantly improve future treatment options for patients with metastatic cancer,” said Karen Aboody, M.D., assistant professor in the divisions of Hematology & Hematopoietic Cell Transplantation and Neurosciences at City of Hope. “It not only has the potential to destroy residual tumor cells, but it should also improve patients’ quality of life by minimizing toxic side effects such as nausea, diarrhea or bone marrow suppression.”

Aboody was the lead author of the study done in collaboration with senior author Mary Danks, Ph.D., associate member in the Department of Molecular Pharmacology at St. Jude Children’s Research Hospital in Memphis, Tenn. The study was published in PLoS ONE, and a second, related paper appeared in Cancer Research.

Most chemotherapy drugs damage fast-growing cells in the body — whether cells are normal or cancerous — which is why the drugs are toxic to tissues such as the intestinal lining and hair follicles.

Aboody and her colleagues have developed a two-part system that may reduce that toxicity. It first infiltrates tumors and then activates a chemotherapeutic drug, providing a killing effect at the tumor site — or sites, if the tumor has spread. The technique takes advantage of the tendency for invasive tumors to attract neural stem cells.

In their study, the researchers injected modified neural stem/progenitor cells into immunosuppressed mice with neuroblastoma tumors. After waiting a few days to allow the stem cells to migrate to the tumors, researchers administered a compound that interacts with an enzyme produced by the neural stem/progenitor cells. That compound converts into an active drug that kills surrounding tumor cells.

The precursor drugs were administered for two weeks. Then, after a two-week break, researchers administered a second round of stem/progenitor cells and drugs.
All of the neuroblastoma mice appeared healthy and tumor-free at six months. All of the untreated neuroblastoma mice died within two-and-a-half months.
The results hold promise for treating solid tumors that metastasize, including neuroblastoma, which represents 6 to 10 percent of all childhood cancers worldwide, with higher incidence in children under age two.

“The results are especially important in the case of high-risk neuroblastoma, because treatment-resistant cancer returns in as many as 80 percent of children, and the majority die of their disease,” Danks said.

Aboody and her colleagues had previously demonstrated the technique’s efficacy in primary and metastatic tumors in the brain. This research is the first to demonstrate that the technique also is effective in a metastatic cancer model, targeting many solid tumor sites spread throughout the body.

They believe that the technique could also be applied to other malignant solid tumors, including colon, brain, prostate and breast cancers, and are planning preclinical trials using those tumors.

The research was funded by grants from the National Cancer Institute, the STOP CANCER Foundation, the Phi Beta Psi Sorority, The Rosalinde and Arthur Gilbert Foundation, the Neidorf Family Foundation, the Marcus Foundation and ALSAC (American Lebanese Syrian Associated Charities).

Markie Ramirez

Karen Aboody


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